Transarterial chemoembolization in soft-tissue sarcoma metastases to the liver - the use of imaging biomarkers as predictors of patient survival.

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Etat: Public
Version: de l'auteur
ID Serval
serval:BIB_281647B9E594
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Transarterial chemoembolization in soft-tissue sarcoma metastases to the liver - the use of imaging biomarkers as predictors of patient survival.
Périodique
European Journal of Radiology
Auteur(s)
Chapiro J., Duran R., Lin M., Mungo B., Schlachter T., Schernthaner R., Gorodetski B., Wang Z., Geschwind J.F.
ISSN
1872-7727 (Electronic)
ISSN-L
0720-048X
Statut éditorial
Publié
Date de publication
2015
Peer-reviewed
Oui
Volume
84
Numéro
3
Pages
424-430
Langue
anglais
Notes
Publication types: Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Résumé
BACKGROUND: The clinical management of patients with metastatic soft-tissue sarcoma of the liver is complicated by the paucity of reliable clinical data. This study evaluated the safety profile, survival outcome as well as the role of imaging biomarkers of tumor response in metastatic soft-tissue sarcoma (mSTS) of the liver treated with conventional transarterial chemoembolization (cTACE).
MATERIALS/METHODS: This retrospective analysis included 30 patients with mSTS of the liver treated with cTACE. The safety profile, overall survival (OS) and progression-free survival (PFS) after the procedure were evaluated. Tumor response in each patient was assessed using RECIST, modified (m) RECIST and EASL guidelines. In addition, a 3D quantification of the enhancing tumor volume (quantitative [q] EASL) was performed. For each method, patients were classified as responders (R) and non-responders (NR), and evaluated using Kaplan-Meier and multivariate Cox proportional hazard ratio (HR) analysis.
RESULTS: No Grade III or IV toxicities were reported in a total of 77 procedures (mean, 2.6/patient). Median OS was 21.2 months (95% CI, 13.4-28.9) and PFS was 6.3 months (95% CI, 4.4-8.2). The enhancement-based techniques identified 11 (44%), 12 (48%) and 12 (48%) patients as R according to EASL, mRECIST and qEASL, respectively. No stratification was achieved with RECIST. Multivariate analysis identified tumor response according to mRECIST and qEASL as reliable predictors of improved patient survival (P=0.019; HR 0.3 [0.1-0.8] and P=0.006; HR 0.2 [0.1-0.6], respectively).
CONCLUSION: This study confirmed the role of cTACE as a safe salvage therapy option in patients with mSTS of the liver. The demonstrated advantages of enhancement-based tumor response assessment techniques over size-based criteria validate mRECIST and qEASL as preferable methods after intraarterial therapy.
Mots-clé
Aged, Aged, 80 and over, Biomarkers, Chemoembolization, Therapeutic/methods, Diagnostic Imaging, Disease-Free Survival, Female, Hepatic Artery, Humans, Liver Neoplasms/mortality, Liver Neoplasms/secondary, Male, Retrospective Studies, Sarcoma/mortality, Sarcoma/secondary, Treatment Outcome
Pubmed
Création de la notice
03/09/2015 11:06
Dernière modification de la notice
20/08/2019 14:07
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